Paulo Domingos Ribeiro-Junior - Academia.edu (original) (raw)

Papers by Paulo Domingos Ribeiro-Junior

Research, Society and Development

A implantodontia vem sendo empregada rotineiramente para reabilitação de pacientes edêntulos, ent... more A implantodontia vem sendo empregada rotineiramente para reabilitação de pacientes edêntulos, entretanto, algumas situações clínicas, como uma atrofia óssea, podem limitar os tratamentos com implantes osteointegráveis (IO). Todavia, o avanço tecnológico da indústria de biomaterais e o desenvolvimento de técnicas de regeneração óssea, possibilitou a reabilitação de pacientes com limitações aos tratamentos com IO. O presente trabalho trata-se um paciente que possuía a região dos elementos dentários 21 e 22 edêntula e com severa atrofia óssea horizontal. Foi realizada Regeneração Óssea Guiada (ROG) com um material aloplástico biocompatível de fosfato de cálcio bifásico, e simultaneamente a instalação de IO estreitos. Após 4 meses de pós-operatorio a RGO e a instalação dos IO foram consideradas clínica e imagenologicamente satisfatórias. ROG é um procedimento aplicável e que pode ser utilizado em regiões com atrofia óssea alveolar horizontal e vertival. No caso clínico estudado foi poss...

Rev. Salusvita (Online), 2019

International Journal of Oral and Maxillofacial Surgery, 2019

Journal of Oral Implantology, 2019

Mandibular reconstruction techniques are always a challenge to oral and maxillofacial (OMF) surge... more Mandibular reconstruction techniques are always a challenge to oral and maxillofacial (OMF) surgeons. Techniques and treatment plans that offer the patient OMF rehabilitation should always be available. Technological innovations have enabled more rapid, safer, and secure treatment than in the past. This article describes a case using a different approach. The patient was treated with marginal mandibulectomy and immediate rehabilitation with osseointegrated implants; a hybrid prosthesis was fabricated a short time thereafter. This treatment plan demonstrated its utility and efficiency in this case. An approach with fewer surgeries and OMF rehabilitation needs be considered in all cases.

International Journal of Oral and Maxillofacial Surgery, 2019

$Research paper thumbnail of Photoelastic analysis of the use of a single plate for the treatment of mandibular angle fractures$

International Journal of Oral and Maxillofacial Surgery, 2019

Background: Owing to differences in paediatric mandibular anatomy, fracture patterns and healing ... more Background: Owing to differences in paediatric mandibular anatomy, fracture patterns and healing progression, conservative versus surgical treatment is still an area of debate. Objectives: Aims: to evaluate the outcome of treatment modalities used in the large cohort of paediatric mandibular fractures. Methods: A retrospective cohort study of 159 pediatricmandibular fractures treated between Jan 2005 to January 2018 was evaluated. Non-surgical group consisted of management with soft diet, active mouth-opening exercises; inter-maxillary fixation or splinting. Surgical group consisted ORIF using titanium miniplates. Outcomes of mouth-opening, occlusion, bony-union, were evaluated till 1-year follow-up. Findings: Male to female ratio was 2:1(66%:34%). Mean age was 6.7-years. Aetiology was fall(75%), RTA(20%). 62% had single fracture; parasymphysis(35%), condylar(34%), symphysis(18%), 38% had combined fractures; 15.7% had bilateral condylar and symphysis; 13.1% parasymphysis and contralateral condyle. Non-surgical modality was preferred in 83% with single fracture and 65% with combined fracture patients. Surgical ORIF modality was used in 17% single and 35% combined fracture with at-least one site of fixation. Condylar fractures were treated nonsurgically. Either modality yielded a satisfactory union and range of motion with good occlusion. None progressed to ankylosis or reduced range of motion even at the end of follow-up period. Hardware was removed in all cases after 6 months. The condylar fracture showed remarkable restitution remodelling even when angulated > 37degrees or overlap > 4 mm. Conclusion: Good results were obtained by either of the treatment; hence, until open surgery demonstrates a consistent functional advantage, nonsurgical managements should be considered the first treatment option. Reference: Smart JM, Low DW, Barlett SP. The paediatric mandible: II. Management of traumatic injury or fracture.

$Research paper thumbnail of Photoelastic analysis of conventional and locking system for treatment of mandibular angle fractures with a single plate$

Journal of Clinical and Experimental Dentistry, 2021

Background This photoelastic analysis evaluated stress distribution in different osteosynthesis s... more Background This photoelastic analysis evaluated stress distribution in different osteosynthesis systems, conventional and locking, used for treatment of mandibular angle fractures with a single plate. Material and Methods Angle fractures were simulated in mandibles made of photoelastic resin. Following Champy’s method, plate osteosynthesis was performed. The samples were divided into five groups: Group 1, non-fractured mandible; Group 2, two screws were installed in each segment using a conventional system; Group 3, two screws were installed in each segment using a locking system; Group 4, three screws were installed in the proximal segment and four screws in the distal segment using a conventional plate; Group 5, three screws were installed in the proximal segment and four screws in the distal segment using a locking plate. In an universal testing machine coupled to a polariscope, a load was applied to the first molar 10 times. The 50 images were randomly numbered and analyzed qual...

A paradental cyst (PC) is an odontogenic lesion, which occurs near the cervical margin of the lat... more A paradental cyst (PC) is an odontogenic lesion, which occurs near the cervical margin of the lateral surface of the root because of an inflammatory process. Generally, they are located on the buccal and distal faces of completely or partially erupted third molar teeth. The purpose of this article is to discuss two uncommon clinical cases of a bilateral PC associated with third molars. Its diagnosed from clinical and radiographic examinations. The diagnosis of a PC was established following the correlation of radiographic, surgical, and microscopic features.

Archives of Health Investigation, 2015

Introducao: O ameloblastoma desmoplasico e uma variante que se caracteriza por estroma densamente... more Introducao: O ameloblastoma desmoplasico e uma variante que se caracteriza por estroma densamente colagenizado e permeado por pequenas ilhas e cordoes de epitelio tumoral odontogenico com pouca tendencia para formar estruturas cisticas. Clinicamente apresenta como um aumento volumetrico indolor, localizado predominantemente na regiao anterior da mandibula; possui pequena predilecao pelo sexo masculino e baixa incidencia entre os tumores odontogenicos. Nos exames de imagem e descrito como uma lesao radiolucida de limites pouco nitidos, semelhante a bolhas de sabao e que pode mimetizar lesoes fibro-osseas. Reabsorcao radicular e neoformacao ossea podem estar presentes. O tratamento e controverso, mas a necessidade de excisao com adequada margem de tecidos nao envolvidos devido ao alto indice de recidivas e necessario. Descricao do Caso: Neste relato de caso clinico paciente, genero feminino, 32 anos, apresentando aumento volumetrico intra bucal, regiao dos elementos 43 e 44, indolor, ...

International Journal of Oral and Maxillofacial Surgery

Craniomaxillofacial Trauma & Reconstruction Open

The implant-supported rehabilitation of atrophic mandibles (AM) with severe bone resorption is ch... more The implant-supported rehabilitation of atrophic mandibles (AM) with severe bone resorption is challenging for both surgical and prosthetic procedures due to the high risk of mandible fracture during implant surgery and postoperatively due to the masticatory load. The aim of case presentations was to demonstrate treatment alternatives for patients with AM who required oral rehabilitation with osseointegrated implants (OIs) according to the residual mandibular bone volume. When bone is 9 mm in height, the ideal treatment is the use of narrow, short OIs. When the bone height is 5 to < 9 mm, mandibular reinforcement with reconstruction plates using the intraoral approach and simultaneous placement of osseointegrated implants are proposed. In cases where bone height is < 5 mm, the choice of treatment is mandibular reconstructive surgery with an autogenous bone graft and biomaterials. The fundamental principles of this protocol are to reduce the morbidity and complications associat...

Journal of Oral and Maxillofacial Surgery

Background: An stable fixation is critical in orthognathic surgery. The change for 3 bi-cortical ... more Background: An stable fixation is critical in orthognathic surgery. The change for 3 bi-cortical screws to only mini-plates is being more commom. Objectives: The aim of this retrospective study was to evaluate the clinical performance of a SSRO osteosynthesis method using only with a single specific bone plate. It is a 6-hole plate with 3 non-linear holes on each side, as horizontal double "Y" semi-curve with variable extension, called Sagittal Plates (SP). Methods: This study evaluated clinical data and medical records data of 71 consecutive patients, who underwent SSRO using the Sagittal Plate for bone fixation. Findings: One hundred and forty two SP were used: fifty eight (40.84%) 9.5 mm plates, thirty four (23.94%) 12.5 mm plates, thirty six (25.35%) 15.5 mm plates and fourteen (9.85%) to 18.5 mm plates. Only intra oral accesses were used without transcutaneous approach. All patients have used a light maxillomandibular fixation with elastics. Four (5.6%) complications were reported: one 1.4% oclusal relapse due to condyle resorption, and three (4.2%) problems related to osteosynthesis. One of them (0.7%) needs performed other fixation. Other Two complications were treated postoperatively with minor ambulatory surgery done after 75 and 90 days post surgery. A major complication, one patient, was related to a large mandibular advancement case, in which 18.5 mm plates were used, and only 2 screws could be used in distal segments. Statistical analysis showed no correlation between postoperative complications and the size of the plate (p = 0,286) or the type of orthognathic surgery performed (p = 0,518). Conclusion: The results of this investigation showed that a SSRO fixation using a single plate with a new design SP provided good stabilization of the mandibular bone segments.

Journal of the Brazilian College of Oral and Maxillofacial Surgery, 2016